For most people with ulcerative colitis (UC), prescription drugs are the best way to reduce symptoms and disease activity. But if you have pain or discomfort that persists, you may choose to look beyond conventional medical treatments to help manage the condition.
Of the many lifestyle-based and alternative remedies that have been promoted to help treat ulcerative colitis, acupuncture has drawn considerable attention. This 2,000-year-old traditional Chinese medicine has grown in popularity in the West in recent decades, both to help reduce tension and stress and to treat pain caused by a variety of conditions, including UC.
Acupuncture is “a great modality for patients with ulcerative colitis to use in conjunction with their traditional medical care,” says Sandi Amoils, MD, a family doctor and the medical director of Alliance Integrative Medicine in Cincinnati, Ohio, who also serves as vice president of the American Academy of Medical Acupuncture.
Dr. Amoils says that acupuncture differs from conventional medical treatments in that “it treats the mind, the body, and the spirit.” She has seen patients with UC experience reductions in pain, fatigue, and even diarrhea following acupuncture treatments.
In one Swedish study, published in November 2016 in the European Journal of Gastroenterology and Hepatology, 21 out of 147 people with UC reported trying acupuncture, with most saying it helped them by:
- Relieving pain
- Increasing overall well-being
- Improving symptoms of UC
A Typical Acupuncture Treatment
While Amoils notes that the exact course of acupuncture treatments will depend on the style that the practitioner uses, there’s a specific process you can expect from almost any practitioner.
Before your first treatment, the practitioner will ask questions about your symptoms and lifestyle, and will examine areas of your body that may include the site of your pain, your face, your tongue, and the pulse in your wrist.
While such an examination may seem strange, Amoils explains that the treatment is tailored to the person and their problem. “It’s not just tailored to the disease process,” she says.
At the beginning of the session, you’ll be asked to lie as still as possible while a practitioner inserts needles in your body. (A typical treatment involves between 5 and 20 needles.)
The locations where needles are inserted are far from random. According to the Mayo Clinic, in traditional Chinese medicine, acupuncture is believed to help balance the flow of vital energy — known as qi (pronounced “chee”) — through pathways in the body known as meridians. By placing needles at particular points in these meridians, practitioners aim to rebalance the flow of energy in your body to heal specific ailments.
“It’s kind of like water running through a river,” says Amoils of qi. When something is wrong in the body, that area is like "a field that gets either not enough water or too much water,” and the acupuncturist aims to find “where the block is in the river, or where there’s too much water coming out.”
A practitioner may also manipulate the needles by moving or turning them, or may apply heat or low-level electrical current to the needles for a short period of time. After 10 to 20 minutes, the needles are removed.
While recommendations vary among practitioners and may depend on your symptoms, an acupuncture treatment plan often consists of one or two treatments a week for a total of six to eight treatments.
The Evidence on Acupuncture for UC
Amoils notes that certain local effects of acupuncture have been confirmed in several studies. Cells change shape when needles are inserted, she says, and they release certain chemicals in response. Changes in blood flow to the brain have been shown in fMRI (functional magnetic resonance imaging) scans following acupuncture treatments.
A number of studies support the effectiveness of acupuncture in certain situations involving chronic pain, according to Jesse Stondell, MD, a gastroenterologist and an assistant professor of medicine at the University of California in Davis. Specifically, he says, it’s been shown to help treat migraine headaches, as well as lower back and knee pain.
But when it comes to ulcerative colitis and IBD more generally, Dr. Stondell says, the evidence is murkier. “We’re left with a bunch of studies that have very different results in very different situations,” he says.
A recent review of studies shows why it’s difficult to get an overall sense of how beneficial acupuncture is for UC. Published in October 2016 in the journal Gastroenterology Research and Practice, the review found that among 63 studies published between 1995 and 2015, there were numerous differences in study design.
These differences included whether the study looked at acupuncture as a stand-alone therapy, in combination with a drug treatment, or in combination with other alternative remedies; where on the body needles were placed; how long treatment continued; and how outcomes were measured.
Most studies on acupuncture and UC, Stondell notes, have compared acupuncture and other alternative treatments with drug treatments — rather than looking at the combined effect of drugs and acupuncture. This approach isn’t very useful, he says, because most people with UC end up needing some sort of medical therapy to obtain remission and do well long-term.
Some of the benefits of acupuncture may also be explained by the placebo effect, in which knowing or believing you are receiving a certain treatment leads to improved outcomes.
Stondell notes that some studies have compared acupuncture with sham treatments — like rubbing someone’s skin with a toothpick — in which participants believed they were getting real acupuncture. “In many of the studies,” he says, “the benefit that the acupuncture group obtained was also obtained by the sham acupuncture group.”
Should You Try Acupuncture?
There’s no question, Stondell says, that some of his patients have seen improved IBD-related outcomes after getting acupuncture. But it’s unclear how, exactly, acupuncture does this.
“Acupuncture may have a real, direct effect,” says Stondell. “It may modulate your nerves. It may change the function of your brain. It may release endorphins.” On the other hand, he says, the person may in part be deriving these benefits because "they’re having someone really try to help them,” which often improves a person’s overall sense of well-being as well as his or her medical outcomes.
If you’re interested in acupuncture, Stondell says, there are few good reasons not to try it out. “If you’re going to a licensed practitioner, the risk of something bad happening is extremely small,” he says. Some private insurance plans even cover a certain number of sessions, so it’s worth looking into whether your plan includes this benefit.
It’s important, though, to discuss your expectations and reasons for trying acupuncture with your doctor ahead of time, and don't stop taking any of your regular treatments for UC. Acupuncture should be “an adjunctive therapy and not a replacement therapy,” says Stondell.
Even if you don’t notice any improvements, Stondell says, you probably won’t regret trying acupuncture. “Of all my patients who have gone to try it, none of them have ever come back and said it was a bad experience,” he says. “They always think it’s interesting.”
While Amoils admits she has a bias towards physicians doing acupuncture, she notes that there are lots of good licensed acupuncturists in communities across the country. “Find somebody who has a good reputation and knows what they’re doing,” she says, “and give it a whirl.”